Assessment of cardiometabolic risk and prevalence of meeting treatment guidelines among patients with type 2 diabetes stratified according to their use of insulin and/or other diabetic medications: results from INSPIRE ME IAA
Faculty of Medicine and Health Sciences
Diabetes obesity and metabolism. - Oxford
, p. 629-641
University of Antwerp
Aim Visceral adipose tissue (VAT) and liver fat (LF) are strongly associated with type 2 diabetes. It is not known, however, how diabetes treatment and/or risk factor management modulates the association between VAT, LF and diabetes. The aim was to determine the level of VAT and LF in patients with type 2 diabetes according to their treatment status and achievement of the American Diabetes Association's (ADA) diabetes management goals. Methods We performed a cross-sectional analysis of the baseline data of the International Study of the Prediction of Intra-Abdominal Adiposity and its Relationship with Cardiometabolic risk/Intra-Abdominal Adiposity (INSPIRE ME IAA), a 3-year prospective cardiometabolic imaging study conducted in 29 countries. Patients (n=3991) were divided into four groups: (i) those without type 2 diabetes (noT2D n=1003 men, n=1027 women); (ii) those with type 2 diabetes but not treated with diabetes medications (T2Dnomeds n=248 men, n=198 women); (iii) those with type 2 diabetes and treated with diabetes medications but not yet using insulin (T2Dmeds-ins n=591 men, n=484 women) and (iv) those with type 2 diabetes and treated with insulin (T2Dmeds+ins n=233 men, n=207 women). Abdominal and liver adiposity were measured by computed tomography. Results Fewer patients with high VAT or LF achieved the ADA's goals for high-density lipoprotein cholesterol (HDL-C) or triglycerides compared to patients with low VAT or LF. Visceral adiposity (p=0.02 men, p=0.003 women) and LF (p=0.0002 men, p=0.0004 women) increased among patients who met fewer of the ADA treatment criteria, regardless of type 2 diabetes treatment. Conclusion Residual cardiometabolic risk exists among patients with type 2 diabetes characterized by elevated VAT and LF.